局部封闭加小针刀治疗肱骨外上髁炎88例

目的观察局部封闭与小针刀联合对肱骨外上髁炎的治疗效果。方法88例初次肱骨外上髁炎患者随机平分为2组,Ⅰ组采用单纯封闭治疗,Ⅱ组采用封闭与小针刀联合治疗,比较2组治疗效果。结果封闭治疗组总有效率为82%(36/44),联合治疗组总有效率为94%(42/44),差异有统计学意义(P<0.05)。结论封闭与小针刀联合治疗肱骨外上髁炎效果优于单纯封闭治疗,建议临床进一步推广。     

锁骨钩钢板治疗锁骨远端骨折和肩锁关节脱位

目的：探讨AO／ASIF锁骨钩钢板治疗锁骨骨折和肩锁关节脱位的疗效。方法：对2004年2月-2007年3月我科收治的30例得到完整随访资料的锁骨骨折和肩锁关节脱位的患者进行回顾性分析，其中，应用锁骨钩钢板治疗的新鲜锁骨外端不稳定骨折23例，陈旧性锁骨外端骨折骨不连患者2例，Tossy grade Ⅲ度肩锁关节脱位5例。结果：30例患者的随访时间为6．46个月，平均27．1个月，骨折全部愈合，肩锁关节无再脱位。按照日本骨科协会评分标准。疗效优28例，良2例。结论：AO锁骨钩钢板治疗锁骨外端骨折和肩锁关节脱位具有固定牢靠，不损伤关节面,早期进行关节功能锻炼，术后关节功能恢复好等优点。     

A unique case of pure lateral spinal cord herniation

BackgroundSpinal cord herniation (SCH) remains a challenging diagnosis for neuroradiologists and may require treatment challenging for neurosurgeons. Most cord herniations are usually found at anterior thoracic levels.Clinical presentationA 28-year-old woman presented at our department with a 7-year history of progressive myelopathy. MR analysis showed a displacement of the spinal cord in a lateral thoracic dural defect. The herniated cord was released using a microscope and the patient significantly recovered 6 months after surgery.ConclusionWe present a unique case of pure lateral SCH. In the light of reviewed literature and operative findings, the underlying pathophysiological mechanisms are discussed.     

Production of reflex cough by brainstem respiratory networks

Delineation of neural mechanisms involved in reflex cough is essential for understanding its many physiological and clinical complexities, and the development of more desirable antitussive agents. Brainstem networks that generate and modulate the breathing pattern are also involved in producing the motor patterns during reflex cough. Neurones of the ventrolateral medulla respiratory pattern generator mutually interact with neural networks in the pons, medulla and cerebellum to form a larger dynamic network. This paper discusses evidence from our laboratory and others supporting the involvement of the nucleus tractus solitarii, midline raphe nuclei and lateral tegmental field in the medulla, and the pontine respiratory group and cerebellum in the production of reflex cough. Gaps in our knowledge are identified to stimulate further research on this complicated issue.     

立体定向脑室镜下侧脑室造瘘术治疗透明隔囊肿

为探讨透明隔囊肿（SPC）的有效治疗方法，对13例SPC患者采用立体定向脑室镜下侧脑室造瘘术治疗。术后11例症状完全消失、2例改善；12例术后复查磁共振成像（MRI）示SPC技术前减小，最大横径平均减小12．6mm；无感染，出血、气颅等并发症发生。认为该术式是治疗SPC的有效方法，其优点是操作简单、创伤小、符合生理特点、疗效确切、无并发症。     

Anatomical Variations in Stylopharyngeus Muscle Insertions Suggest Interindividual and Left/Right Differences in Pharyngeal Clearance Function of Elderly Patients: A Cadaveric Study

The stylopharyngeus plays a critical role in the clearance of the piriform recess. We dissected 78 sides of the pharynx from 55 donated cadavers and observed histology of another seven sides of the pharynx from seven cadavers. The stylopharyngeus consistently comprised (1) a descending muscle bundle surrounding the piriform recess and (2) an additional short sheet inserting into the tonsillar bed. Histologically, the former bundle connected to a thick fascia providing the lateral glossoepiglottic fold, extending along the submucosa of the piriform recess, and covering the thyroid cartilage, whereas the latter sheet intermingled with other pharyngeal wall muscles at and near the tonsillar bed. Notably, in 44.4% of female specimens, the additional sheet occupied a greater proportion in cross section than the descending muscle bundle. Given the different directions, the additional sheet seemed to check clearance function of the descending bundle for the piriform recess. Thus, particularly in women, interindividual differences in pharyngeal clearance were likely to depend on whether the additional sheet is strong or weak. Chin down in combination with tilting and rotating the head may represent effective exercises of the stylopharyngeus that could compensate for the disadvantages of additional insertion.     

Laboratory validation of a lateral flow device for the detection of CyHV-3 antigens in gill swabs

Cyprinid herpesvirus-3 (CyHV-3) induces the highly contagious koi herpesvirus disease (KHVD) and may result in significant economic losses to the ornamental and food-producing carp industry. Suspicion of KHVD is triggered by clinical signs and confirmed using laboratory techniques. The latter are labour- and time-consuming, require specialised equipment and trained personnel. For rapid, on-site detection of CyHV-3, a lateral flow device (LFD) was developed using two monoclonal antibodies directed towards the viral glycoprotein ORF65. The LFD was highly specific with analytical and diagnostic specificities of 100%. Analytical sensitivity ranged between 1.25 × 10² and 2.40 × 10⁴ plaque forming units per ml for isolates originating from geographically distinct regions. In experimentally infected carp, CyHV-3 was detected as early as 4–5 days post infection. Diagnostic sensitivities of 52.6% and 72.2% relative to PCR were recorded, depending on the viral isolate used. When onset of mortality was taken as reference, diagnostic sensitivities increased to 67.0% and 93.3%. The diagnostic sensitivity for freshly found-dead animals was 100%, irrespective of the virus isolate used. Given the high specificity and ease-of-use for on-site detection of CyHV-3, the LFD was regarded fit for purpose as a first-line diagnostic tool for the identification of acute CyHV-3 infections in KHVD affected (koi) carp.     

Challenges in diagnosis of motor neuron disease: A case series of ALS mimic syndromes

Amyotrophic lateral sclerosis (ALS) is most often a sporadic disorder that affects both upper and lower motor neurons. Because the prognosis of ALS is uniformly poor compared to other motor neuron disorders, defining the diagnosis can help guide appropriate clinical management and improve quality of life for patients. However, the diagnosis of ALS is often challenging and there may be overlapping clinical features with other rare diseases. We present four patients who were referred to our center because of the clinical suspicion of ALS, in whom more detailed assessments revealed an alternative diagnosis, and we discuss the limitations of the modified-El Escorial criteria.